Washington U.S. District Court judge tells Blue Cross Blue Shield of Illinois to include gender affirming care

TACOMA — A U.S. District Court judge in the Western District of Washington instructed Blue Cross Blue Shield of Illinois (BCBSIL) to end discriminatory exclusions on gender-affirming health care and to reprocess claims for gender-affirming care that BCBSIL health plans previously denied.

U.S. District Court Judge Robert Bryan’s order on Wednesday in Tacoma forbids BCBSIL from denying gender-affirming care even when requested by an employer, according to a press release by American civil rights organization, Lambda Legal. BCBSIL is headquartered in Chicago, Illinois.

Lambda Legal, with Sirianni Youtz Spoonemore Hamburger PLLC, represented the three plaintiffs who said they were denied gender-affirming care in BCBSIL health plans.

The case was initially filed by C.P., a now 18-year-old transgender young man, and his parents. The original plaintiffs were joined by S.L., a 12-year-old transgender girl, by and through her parents, and Emmett Jones, a transgender man.

Ele Hamburger, with Sirianni Youtz Spoonemore Hamburger PLLC, said the original plaintiff C.P and his mother Pattie Pritchard are Washington residents.

In December 2022, the court concluded that BCBSIL discriminated against transgender enrollees when it enforced exclusions of gender-affirming care, even in self-funded plans that may be designed by employers.

After the court’s decision, BCBSIL continued to enforce exclusions in 2023, according to the release. The plaintiffs moved for a permanent injunction and reprocessing after the 2022 conclusion to force BCBSIL to adhere to the court’s legal conclusion, according to Lambda Legal.